Schlitt Hans J, Hackl Christina, Lang Sven Arke
Department of Surgery, University of Regensburg Medical Center, Regensburg, Germany.
Department of Surgery, University of Freiburg, Freiburg i.Br., Germany.
Visc Med. 2017 Dec;33(6):408-412. doi: 10.1159/000479850. Epub 2017 Nov 29.
Liver tumors that are extensive, multifocal, or critically located frequently require advanced techniques of liver resection including '!' - enabling liver resection in certain situations.
The development of the technique in the first and the subsequent 8 patients in the index center, and also the method's spread throughout Germany and the world were reviewed.
In 2007, in the first patient, the new technique was developed intraoperatively by necessity. Due to the convincing outcome, it was deliberately applied again several months later in another patient, and thereafter (sparsely) used for liver resection for various indications. Following oral communication, the method spread throughout Germany, and later - mainly following the publication of the initial multicentric German series - very quickly disseminated worldwide. Currently, it is used for a very (if not overly) broad spectrum of indications by many hepatobiliary surgery centers.
In-situ split/ALPPS is a newly developed technique for liver resection, which was established for very specific situations. This method has created a hype, and is currently used rather generously by many centers worldwide.
广泛、多灶性或位置关键的肝肿瘤常常需要先进的肝切除技术，包括“！”——在某些情况下能够实现肝切除。
回顾了该技术在索引中心首例及随后8例患者中的发展情况，以及该方法在德国乃至全球的推广情况。
2007年，首例患者因手术需要在术中开发了这项新技术。鉴于令人信服的结果，几个月后又特意在另一例患者中再次应用，此后（偶尔）用于各种适应证的肝切除。经口头交流，该方法在德国传播开来，后来——主要是在德国多中心系列研究首次发表之后——迅速在全球传播。目前，许多肝胆外科中心将其用于非常（即便不算过度）广泛的适应证。
原位劈裂/联合肝脏分隔和门静脉结扎的二步肝切除术（ALPPS）是一种新开发的肝切除技术，专为非常特殊的情况而设立。该方法引发了热潮，目前全球许多中心都相当广泛地使用。
